TMD - Diagnostic Classification Flashcards
How can common causes TMD issues be split?
Musculature
Articular disc - disc disorder
Mixed diagnosis
What is TMD disorder defined as?
Collective term for number clinical problems involving masticatory muscle, tempromandibular joint and associated structured
What are muscle of mastication innervated by?
Mandibular division trigeminal nerve
Examples of masticatory muscle disorders?
Myalgia
- Local myalgia
- Myofascial pain w/ or w/o referral
What muscles are often affected during musculature pain?
Large closing muscle - temporalis/ masseter
Signs/ symptoms of masticatory muscle disorders?
Familiar pain in muscle on function/ parafunction or palpitation
Examples of true tempormandibular joint disorders?
Arthralgia
Disc disorders
Degenerative joint disease
Subluxation
What is arthralgia?
Joint pain in TMJ
What are types of disc disorder?
Disc displacement w/ reduction
DD + R w/ intermittent locking
DD - R w/ limited opening
DD - R w/o limited opening
How diagnose degenerative joint diease?
Panoramic imaging - OPT
CT gold standard
What causes TMJ subluxation?
TMJ hyper-mobility causes condyle subluxation - goes beyond eminence
What is myofasical pain w/ referral ?
Pain beyond boundary of muscle being palpated
How can referred pain in myofascial pain present?
Toothache, headache, earache
Most common disc disorder?
DD + R
What is DD+R?
Disc displacement w/ reduction
Disc position isn’t maintained on condyle throughout range of movement
Where is disc positioned in DD+R?
Disc is anteriorly displaced
What happens to disc on opening in DD+R?
The disc reduces - normally during midrange = hear click
What happens to disc on closing in DD+R?
Disc displaced anterior
What movement pattern expect in DD+R?
Ipsilateral deviation w/ opening which corrects - caused disc being infront of condyle initially but then returns to condyle
Sign/ symptoms DD+R?
TMJ clicking on function and movement
Familiar pain TMJ
What is DD+R w/ intermittent locking?
Disc still displaced anteriorly
During opening jaw becomes locked as disc no longer relocates onto condyle
What see in pt w/ DD+R w/ intermittent locking?
Will have jaw manoeuvre - here click as disc returns to condyle
What is DD - R?
Progression disease
No reduction - disc no longer relocates to condyle instead folds in front of condyle
During opening no reduction of displaced disc
What see on condylar head in DD-R?
Condylar head abnormal w/ thinning of articular cortex
What two types of DD-R?
w/ OR w/o limited opening
What symptoms see DD-R?
Limited mouth opening
Limited contralateral excursion
Familiar pain TMD
When see DD-R w/o limited opening?
Chronic phase - joint become stretched allowing nearlly full ROM
What movement pattern see in DD-R?
Ipsilateral deviation which doesn’t correct itself - disc remains infront of condyle
What is common to see in DD-R?
Limited opening
When more likely see DD-R w/o limited opening?
When capsule and ligaments have stretched allow ROM
Takes months - years
What expect to see on OPT degenerative joint disease?
Joint space narrowing
Subchondrial scelorisis - increased opactiy
Subchondiral cyst and erosiosn
Sign and symptoms of joint degeneration?
Limited ROM/ opening
Crepitus on function
Familia pain
Signs/ symptoms of subluxation?
TMJ clicking
Lock wide-open position
Excessive mouth opening
Difference between subluxation and luxation?
Subluxation - pt able to reduce dislocation
Luxation - require interventional reduction
What is excessive mouth opening?
> 50mm
